| NPI | 1124424973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-18-33225) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: IN 1-18-33225) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2025-09-04 |